ICBT for OCD

Inference-Based Cognitive Behavioral Therapy (ICBT)

ICBT is a newer, evidence-based treatment for OCD that focuses on unwinding from obsessional doubt. ICBT does not involve planned exposures.

ICBT treatment is almost like taking a class about how your OCD symptoms work and why you’ve been tricked into believing your own obsessional doubts, whatever they may be. In ICBT, I work collaboratively with clients through a planned curriculum in which they learn to identify their primary doubts. They learn that they are both irrelevant and imaginary, and can therefore be dismissed. Many wonder if this is the same as reassurance seeking or “arguing with the OCD,” but this is not the case. ICBT never involves arguing with the content of OCD concerns. Instead, the focus is on unwinding from the faulty reasoning process that led you into those doubts in the first place.

ICBT focuses on targeting two mechanisms that maintain OCD: inferential confusion and the feared possible self.

• Inferential confusion - individuals with OCD come to conclusions about themselves and the world by over-relying on hypothetical possibilities, ignoring information from their inner and outer senses, and getting confused by drawing connections between situations that are actually unrelated

• The feared possible self - individuals with OCD fear that there is some negative version of themselves that they might become if they are not careful at holding it at bay. The feared possible self does not genuinely exist, but individuals are terrified that it may come to exist if they refrain from compulsions.

ICBT helps individuals see where they are becoming inferentially confused and to learn that their feared possible self is not a real concern.

ICBT is a good fit for clients who have tried ERP (exposure and response prevention) with limited success. It could also be a fit for clients who like working through a planned curriculum, or who are curious to better understand their OCD with the purpose of letting it go.